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The Hip Chronicles, Part V: I’m a big girl now

In my series, the RA Diaries, I’ve tried to write about the weird, the painful and even the comical parts of having a chronic illness. Very recently, I had what for many RA patients is a rite of passage: my first joint replacement. My new right hip, with its festive combination of titanium, cobalt and plastic polymer, is worth five times more than my car. And it will surely be a great source of amusement to TSA scanners worldwide, because on x-rays it looks like I’m packing some major heat.

Now, kind reader, let me tell you exactly how I went about getting my new hip. But be warned. It’s gonna get gross. And graphic. And, maybe once in a while, somewhat amusing. I hope you get something out of it. I’m certainly hoping I will.

While I was preparing emotionally for my surgery, I figured there would be pain. And blood. And needles. And uncomfortable robes and bland food and people constantly prodding me and poking me and asking intimate questions and interrupting me when I tried to sleep. After all, I had seen a number of my loved ones go through surgery, and these were the things they complained about most.

But I didn’t quite expect how much, once my surgery was over, I would regress to an earlier version of myself, a version I had never expected to be again.
In the recovery cubicle, it was like I was a newborn, confused and distressed and completely dependent on the adults around me. The hospital bed was my crib, and like all infants, I had to lie on my back lest something bad happened. I was too weak to raise my head, or sit up, and my legs were strapped down so I couldn’t cross them. Lying on either side was not allowed. My best view was of the ceiling (I would have killed for a mobile, preferably one with fish. Later, I got a flat-screen TV.).

At that point, I wasn’t allowed solid food. For that matter, I wasn’t even allowed water. All liquids were administered through an IV, my ersatz umbilical cord. Then, there was the catheter, which is a diaper substitute. Pre-op, I had dreaded the idea of getting a catheter, but while in recovery, I appreciated it, because the idea of lifting my lower body high enough off the bed to use a bed pan seemed impossible. Happily for me, the catheter was inserted while I was still unconscious, so I didn’t have to deal with the image or sensations of some nurse performing the procedure.

The next day, established in my room, I got to grow up a little. I was still on the IV and the catheter, but I was allowed to drink and eat. Since my throat still hurt from the intubation, I stuck to mushy food, like scrambled eggs and vanilla ice cream. I had no appetite for either. They tasted as icky as baby food.

I was visited by both a physical therapist and an occupational therapist, and each had the goal of getting me out of bed and on my feet as quickly as possible. Sitting up felt impossible — hell, just moving my operated leg across the bed and sitting on the edge felt impossible. But my determination to take my new hip for a test run won out, and the physical therapist soon had me up and on a walker.

That’s when my RA had its revenge — my bent elbows and weak wrists and hands weren’t happy using the standard walker, and taking four teeny steps felt like climbing Everest. I was so disappointed. What if I never walked again? Dammit, why had I had this stupid surgery in the first place?

Fortunately, the next physical therapist found me a walker with elbow supports. Once I got on that, walking again felt attainable.

But all that’s just the physical part of my regression. While I can’t honestly say I was prepared for such a complete loss of bodily autonomy, I did have some concept of what would happen. I certainly didn’t expect to be able to tango the day after surgery, and was resigned to being unable to drive a car for at least two months.

More shocking was how little control I suddenly had over my emotions. Very young children are not known for their stoicism — a baby who doesn’t howl on a regular basis tends to be viewed with suspicion, and toddlers are expected to throw tantrums occasionally. But a late 30-something? You don’t expect her or him to howl at the slightest provocation. Yet that’s exactly what I did. Those first few days, I went from being perfectly composed to sobbing and hiccuping and completely losing it in less than a minute.

The first day was the worst — I lost it with the surgeon, the nurse, my family, the occupational therapist and several orderlies. I also lost it on the phone with my sweet best friend. Most of the recipients of my tears were very kind. Awkward (I’ve been on the receiving end of such episodes, and they can be paralyzing), but kind.

Even now, three weeks after that first day, the tears are much closer to the surface than they ever were pre-surgery. They seem to lurk closest when I need my pain medication. I’m not sure why I feel this way — I imagine it’s a number of things, including the narcotics I’m on and the trauma I’ve been through.

But the sudden crying isn’t the only issue. While in hospital, I seemed to lose most of my inhibitions. I tend to be a very private person (this blog notwithstanding), particularly about bodily functions. It’s not that I’m a prude, exactly, but I try to handle certain things in private. I always close the door when I am in the bathroom. I try not to let gas escape from various orifices — at least not loudly — while in public. I don’t discuss my excretory habits with anyone, and I’m really not into scatological humor (which is why I often get tired of “South Park’s” never-ending faecophilia).

But just a day into my hospital stay, all those inhibitions were gone. Like a toddler, I had no problems announcing to family or complete strangers when I needed to go. I was completely unapologetic about the various noises and smells that emanated from my body at inopportune times.

And the idea of a whole cadre of residents, nurses, assistants or orderlies seeing my naked flesh, whether to change the dressing, bathe me, check me for bedsores or even wipe my ass (this was pre-Bottom Buddy) didn’t faze me in the least.

A quick example — on my second day in the hospital, I had a nurse named Jack. Jack was in charge of giving me my meds every few hours. He was also in charge of keeping track of my bowel movements.

Shortly after he introduced himself to me that day, he took my vitals. Then he asked if I had moved my bowels yet. I told him no, but then again, I had barely eaten a thing since the day before surgery. He told me the hospital could not release me until I dropped a couple of kids off in the pool. I promised him I would try. He listened to my gut through his stethoscope and seemed doubtful.

“There’s not a lot of movement there.”
“It was going crazy earlier,” I assured him, but he was not convinced.

Now here’s the thing — Jack was gorgeous. Like, model gorgeous. He was tall, with thick straight brown hair and delicate features. He also wore glasses, which gave him an intellectual air. In fact, he had the exact look I lusted after throughout school. If a guy who looked like him had even looked at me back then, I would have been ecstatic. Tongue-tied, but ecstatic.

I certainly wouldn’t have discussed my bowel movements with such a guy. In fact, I would likely have died of embarrassment had the word “bowel” come up in conversation.

What a difference a few years — and a lot of Percocet — can make.

A few hours into Jack’s shift, it happened — the act which would hopefully help me leave the hospital on schedule. After, I was so proud of myself. I was every bit as proud as I was when I finished college, flew solo or got my first piece published. (Did I mention I was on Percocet?) And I couldn’t wait to tell Jack. Had I been mobile, I would have rushed to the nurse’s station to tell him. But since I couldn’t, I waited until it was time for my next dose.

He was barely in the door when I blurted it out.
“Guess what, Jack? I had a bowel movement!”
He nodded and made a note in my chart.

His lack of reaction was very disappointing. Surely he should have high-fived me or something? He gave me my pill, and I took it. Then he left.

As I lay in my hospital bed, waiting for the meds to work, I reflected on my reaction to Jack’s lack of reaction. It was a childish reaction. But I was not a child.

I am not a child. I’m a big girl now.

All text copyrighted by A.K. Whitney, and cannot be used without permission.

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6 comments

Your posts — this one included — give me renewed empathy for my patients who have to deal with this stuff all the time.

The thing that I was thinking as I read this post was just what it means to get in touch with our humanity: our creatureliness; the fact that we really are vulnerable as much as we hate to admit it. I, for one, have struggled with coming to terms with that vulnerability, that part of my humanity, but I’m getting better! Your honesty and vulnerability with us is encouraging.

Thank you! One of the things I liked so much about my surgeon is that he had had a knee replacement at some point, so he knew almost exactly what I was going through. Maybe all health professionals, and members of the caring professions, should either go through a major procedure or be there when a family member does, so that they can really feel what it’s like. Then again, you are a very empathetic person, so I’m not necessarily prescribing that for you!

I think that the “no inhibitions” thing is good – like a survival tactic that kicks in. It’s our way of getting the care that we need. It really is strange how anesthesia affects people. Just about everyone I know who’s been put under has gotten really emotional afterward. One of those side effects that no one talks about…which is why it is so great that you are sharing your experience.

Thanks for this post. I was recently in a car accident and sustained fractures to my hip and tailbone. What you describe here – especially about having to depend on others and feeling like a child – reminded me of my hospital stay and the weeks afterward. Everyone (mostly – the respiratory therapists were really rude) was wonderful, but I really was not ready for how immobile I would be.